湖北省部分地区2011--2012年度麻疹流行期间高发原因调查

陈邦华; 官旭华; 詹发先; 邢学森; 赵明江; 王雷; 张丽杰

Abstract

陈邦华,官旭华,詹发先,邢学森,赵明江,王雷,张丽杰.湖北省部分地区2011--2012年度麻疹流行期间高发原因调查[J].Chinese journal of Epidemiology,2013,34(7):714-716

湖北省部分地区2011--2012年度麻疹流行期间高发原因调查

Investigation on the risk factors for reported rising of measles incidence during November, 2011 to February, 2012.in some areas of Hubei province

Received:April 19, 2013

DOI：10.3760/cma.j.issn.0254-6450.2013.07.012

KeyWord: 麻疹疫苗危险因素医院感染

English Key Word: Measles Vaccination Risk factors Nosocomial transmission

FundProject:

Author Name	Affiliation	E-mail
CHEN Bang-hua	Wuhan Center for Disease Control and Prevention, Wuhan 430015, China Chinese Field Epidemiology Training Program.Chinese Center for Disease Control and Prevention
GUAN Xu-hua	Hubei Provincial Center for Disease Control and Prevention
ZHAN Fa-xian	Hubei Provincial Center for Disease Control and Prevention
XING Xue-sen	Hubei Provincial Center for Disease Control and Prevention
ZHAO Ming-jiang	Hubei Provincial Center for Disease Control and Prevention
WANG Lei	Hubei Provincial Center for Disease Control and Prevention
ZHANG Li-jie	Chinese Field Epidemiology Training Program.Chinese Center for Disease Control and Prevention	cfetpzlj@126.tom

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Abstract:

目的探讨2011年11月湖北省部分地区麻疹发病率突然升高的原因。方法选取2011年11月至2012年2月“湖北省麻疹监测信息报告管理系统”中报告麻疹发病率突然升高的w市和H市所有麻疹病例, 通过查阅预防接种证了解病例麻疹疫苗接种史, 并估算适龄儿童疫苗接种率。运用病例交叉研究, 电话调查监护人, 了解病例在麻疹发病前7～21d(潜伏期内)和发病前37~51 d内就诊情况。结果调查两市共报告麻疹病例140例, 其中<8月龄和8～17月龄婴幼儿发病率较高(分别为69/10万和72/10万), 其他年龄组发病率为0-5.8/10万。8～17月龄婴幼儿麻疹疫苗估算接种率<75%, 18月龄至3岁组接种率<90%。58%的病例在发病前7～21 d内有就医史, 而发病前37~51 d内去医疗机构的病例占14%(RR=5.4, 95%CI：2.1~14.O)。结论在麻疹疫苗接种率不达标的情况下, 儿童的医院暴露可增加麻疹发病风险

English Abstract:

ObjectiveTo identify the risk factors for reported sudden rise of measles incidence in November.20 11.in some areas of Hubei province.MethodsWe analyzed all measles patients reported in the measles surveillance system from November 2011 to February 2012 in two prefectures with highest attack rates and their vaccination history by reviewing vaccination records.We interviewed patients'parents by telephone to obtain the history of visiting health care within 7 to 21 days before onset.Wj also used case.crossover study to estimate the relative risk(RR)of hospital acquired infection and to compare the exposure to health care between 7-21 days before onset to37-51 days before onset among measles patients.ResultsTotally 140 patients were reported in the two prefectures.Reported measles incidence rates among the population aged<8 m(69/100000)and 8 m to 17 m(72/100000)were higher than other age groups(rang from 0 to 5.8 per 100000).Among the population aged 8 m to 17 m.estimated vaccination coverage was lower than 75%.and it was lower than 90%among those aged 18 m to 3 yrs.During 7-21 days before onset, 58%(29/50)of the patients had an exposure to health care settings, compared to 14%(7/50)of patients during 37 to 51 days before onset(MH RR=5.4.95%confidence interval=2.1-14.0).ConclusionUnder the condition of measles vaccination coverage 10wer than 95%.iatrogenic infection was a risk factor for measles in Hubei．

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